Document Detail


Clonidine provides opioid-sparing effect, stable hemodynamics, and renal integrity during laparoscopic cholecystectomy.
MedLine Citation:
PMID:  11727145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Carbon dioxide pneumoperitoneum causes a hemodynamic stress response and decreases urine output because of an activated renin-angiotensin-aldosterone system (RAAS). Clonidine is a potent antihypertensive drug that suppresses RAAS. METHODS: The effects of clonidine 4.5 mg/kg or saline on hemodynamics, neuroendocrine response, and renal parameters were compared in 30 healthy patients undergoing laparoscopic cholecystectomy. RESULTS: Heart rate, arterial blood pressures, and plasma renin activity were lower during and after pneumoperitoneum in patients with clonidine. There were no differences in urine output, urine oxygen tension (reflecting medullary perfusion), or antidiuretic hormone between the groups. N-acetyl-b-D-glucosaminidase, a marker of proximal tubular damage, was minimally elevated after clonidine. CONCLUSIONS: Clonidine enabled stable hemodynamics and prevented activation of RAAS seen as unchanged plasma renin activity. Clonidine may be beneficial during laparoscopy in patients with hypertension, cardiovascular, and/or renal diseases.
Authors:
M Laisalmi; A M Koivusalo; P Valta; I Tikkanen; L Lindgren
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Randomized Controlled Trial     Date:  2001-08-16
Journal Detail:
Title:  Surgical endoscopy     Volume:  15     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-11-29     Completed Date:  2002-03-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1331-5     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Intensive Care Medicine, Surgical Hospital, Helsinki University Central Hospital, 00029 HUS Helsinki, Finland. merja.laisalmi@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / administration & dosage
Cholecystectomy, Laparoscopic / methods*
Clonidine / administration & dosage*
Double-Blind Method
Heart Rate / drug effects
Hemodynamics / drug effects*
Humans
Injections, Intramuscular
Kidney Function Tests
Middle Aged
Pneumoperitoneum, Artificial / adverse effects
Premedication
Prospective Studies
Renin / blood
Renin-Angiotensin System / drug effects
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 4205-90-7/Clonidine; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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